Targeted Nipple–Areola Complex Reinnervation

As a plastic surgeon at Oregon Cosmetic and Reconstructive Clinic, I spend a lot of time thinking about how surgery affects not just shape, but also function and feeling. Today I want to share a newer option that may interest some patients: targeted nipple–areola complex (NAC) reinnervation.

This technique focuses on sensation. Specifically, it aims to improve feeling in the nipple graft after chest surgery that uses free nipple grafts.

Why Sensation Matters After Chest Surgery

After chest surgery with free nipple grafts, most patients heal well and like their chest shape. However, sensation can be unpredictable.

Without added nerve work, about 60% of patients regain some touch sensation.

The feeling is often light touch and may feel different than before surgery.

Because sensation matters to somepatients, surgeons continue to look for ways to improve these outcomes. That’s where targeted reinnervation comes in.

What Is Targeted Nipple–Areola Complex Reinnervation?

Targeted NAC reinnervation is a surgical technique designed to reconnect sensory nerves to the nipple graft. The goal is simple: help nerves grow into the graft and improve sensation over time.

This procedure is an option for patients who are already planning chest surgery with free nipple grafts and want to maximize their chance of regaining feeling.

How the Procedure Works

During surgery, I take several careful steps:

First, I identify and mark the intercostal sensory nerves along the sides of the chest.

Next, I preserve the nerve length, which is key for healing and nerve growth.

Then, I create a small tunnel through the tissue toward the skin surface.

Finally, I bring the nerve ends to the area where the nipple grafts are placed.

By positioning these nerves close to the graft, we give the body a clearer pathway for sensation to return.

Who May Benefit From This Procedure?

Targeted NAC reinnervation may be a good option if you:

Are planning chest surgery with free nipple grafts

Want to increase the chance of nipple sensation after surgery

Understand that nerve healing takes time and varies from person to person

This technique is not required for everyone. Instead, it is an add-on option for patients who value sensation as part of their surgical goals.

What Are the Expected Results?

Based on current experience and data:

Patients who undergo targeted NAC reinnervation have about an 80% success rate in regaining sensation.

Patients who do not have this procedure typically regain sensation at a rate closer to 60%.

While no technique can guarantee full or normal sensation, targeted reinnervation clearly improves the odds for many patients.

The Role of Sensory Mapping During Recovery

For patients who choose targeted nipple–areola complex reinnervation, recovery includes more than healing incisions. Sensory mapping exercises play an important role in helping the brain reconnect with the healing nerves.

As nerves regrow, the brain needs guidance to understand where new sensations are coming from. Sensory mapping helps with this process.

During recovery, I recommend:

Gently touching different areas of the chest and nipple graft

Noting where sensation feels sharp, dull, warm, or light

Repeating these exercises regularly over time

These simple exercises train the brain to recognize new nerve signals. Over time, this practice can improve how sensation feels and how clearly it is perceived.

Importantly, sensory mapping does not speed up nerve growth. Instead, it supports better nerve awareness and integration as healing progresses. When paired with targeted reinnervation, this active participation helps patients get the most out of the procedure.

Thoughtful, Personalized Surgical Planning

At Oregon Cosmetic and Reconstructive Clinic, I believe good surgery starts with good conversations. Targeted nipple–areola complex reinnervation is one more tool we can use to personalize chest surgery and focus on both form and function.

If sensation is important to you, we can talk through whether this option fits your anatomy, goals, and overall surgical plan.